Novosti
Khirurgii
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Year 2011 Vol. 19 No 4

GENERAL AND SPECIAL SURGERY

L.M. CHERNUKHA, A.A. GUCH, M.O. ARTEMENKO, G.G. VLAYKOV, I.V. GOMOLYAKO, T.D. ZADOROZHNAYA, A.V. TODOSYEV

MODERN APPROACHES IN DIAGNOSTICS AND SURGICAL TREATMENT OF VENOUS FORMS OF CONGENITAL VASCULAR MALFORMATIONS OF THE LOWER LIMBS

Objectives. Improvement of diagnostics and treatment results of patients by using differentiated pathogenetically grounded approach to treatment using surgical, laser and echosclerosing techniques.
Methods. 98 patients were examined and subjected to surgical treatment. Examination included color duplex scan of lower limbs vessels, ultrasound of the surrounding soft tissues; X-ray contrast phlebography; markers of proliferation were determined: the signs of dysmorphism at the morphological level and revealing of the expression level of the receptor to VEGF Flk-1/KDR (VEGFR2); pathomorphological and immunohistochemical investigation. All the patients were divided into 4 groups: stem forms with the lesions of superficial venous system (59 patients, 60,20%); stem forms with lesions of deep venous system (27 patients; 27,55%); extra-stem forms (7 patients, 7,14%); combined forms of lesions (5 patients, 5,10%).
Results. Treatment results of patients were assessed by 2-point scale based on D.A. Loose, B.B. Lee. In 73 (74,49%) patients satisfactory long-term results were obtained, poor results were obtained in 25 (25,51%) patients.
Conclusions. Pathomorphological and immunohistochemical studies indicate the proliferative activity of malformations. Treatment of patients with venous forms of congenital vascular malformations of the lower limbs should be differentiated and include surgical, laser and echosclerosing techniques.

Keywords: congenital vascular malformation, vascular endothelial factor of growth, endovasal laser coagulation of veins, venous form, echosclerotherapy
p. 48 54 of the original issue
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